NPIMap

Organization Active NPI

Afc Physicians of Georgia Primary Care, PC

  • Primary Care Clinic/Center
  • Fort Oglethorpe, GA
National Provider Identifier
1780062380
Registry record updated Feb 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
AFC PHYSICIANS OF GEORGIA PRIMARY CARE, PC
Practice address
26 Battlefield Pkwy
Ft. Oglethorpe, GA 30742-4004
Phone
(706) 956-2846
Fax
(706) 956-2850
NPI assigned
May 14, 2015
Last updated
Feb 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Randy Johansen
Title
President
Phone
(205) 403-8902

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X
Primary Care Clinic/Center 261QP2300X Primary
Urgent Care Clinic/Center 261QU0200X

Addresses

Primary practice location

26 Battlefield Pkwy
Ft. Oglethorpe, GA 30742-4004

Mailing address

3700 Cahaba Beach Rd
Birmingham, AL 35242-5225
Phone (205) 403-8902

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160229001243 GA Part B Supplier - Clinic/Group Practice 3072818095 Receives reassigned benefits from 43 practitioners
1 other NPI on this enrollment
Practice locations: Ft Oglethorpe, GA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 52

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 52

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676851200000",
    "number": "1780062380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 CAHABA BEACH RD",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352425225",
            "telephone_number": "205-403-8902",
            "fax_number": "205-421-2109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 BATTLEFIELD PKWY",
            "city": "FT. OGLETHORPE",
            "state": "GA",
            "postal_code": "307424004",
            "telephone_number": "706-956-2846",
            "fax_number": "706-956-2850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFC PHYSICIANS OF GEORGIA PRIMARY CARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-14",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A",
        "authorized_official_last_name": "JOHANSEN",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "205-403-8902",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Oglethorpe, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.